PATIENTS’ MANAGEMENT OUTCOME OF TRIAGED AND CODED PATIENTS AT ACCIDENT AND EMERGENCY DEPARTMENT, KENYATTA NATIONAL HOSPITAL, KENYA

Abstract

The goal of triage is to prioritize patients who require the most urgent care and increase efficiency when resources are insufficient to treat all patients as per their degree or grade of injury. An effective and efficient emergency center triage system should be able to sort both trauma and non-trauma patients according to level of acuity. It also involves treatment as per the physiological parameters, either coded as red, orange, yellow, green or black. Kenyatta National Hospital has adopted the South African Triage Score (SATS) which has proven to be effective in monitoring the patient’s physiological parameters, it involves the use of a score form called triage early warning scores (TEWS). Several studies have found that emergency triage is an effective way to speed up the triage process, decrease waiting times, and boost patient outcomes in first-world nations. Low-income or limited-resource situations, on the other hand, present unique obstacles that might have a substantial effect on the selection and application of the most suitable triage scale and the success of its implementation. Some of the examples of such challenges include shortages of material and human resources, poor record keeping practices, as well as space. The broad objective of the study was to evaluate the outcome of triaged and coded patients at accident and emergency department, Kenyatta National Hospital. The study was a cross sectional study involving the triaged and coded patient’s flagged by scores using the Triage Early warning score (TEWS) whereby structured questionnaire were used as well as an observation checklist. Study site was accident and emergency department, Kenyatta National Hospital. The target population were all coded patients at accident and emergency unit, a sample of 385 patients were used during this study, data collection was through structured questionnaires and checklist to assess the healthcare provider and institutional related factors. Pilot study was done at Kakamega county referral hospital. Data analysis was done using statistical package for social sciences (SPSS) version 25, descriptive and inferential statistics was used to test the associated of the factors in relation to the outcomes. Odds ratio was used to test the strength between the provider and health facility factors associated with the management outcome of triaged and coded patients, a one-way analysis of variance was be used to the differences in mean scores in the institutional and provider factors. Data was presented in tables and bar graphs. The study results indicated that patient related factors had significant influence on management outcome of triaged patients’ (t-statistic=.210, pvalue = 0.039 < 0.05). The other findings revealed that provider related factors had significant influence on management outcomes of patients triaged (t-statistic=13.055, pvalue= 0.002< 0.05). Further study results indicated that there was a positive and significant relationship between institutional related factors and management outcome of triaged patients’. This is depicted by a Pearson correlation coefficient r=0.452 p-value =0.008< 0.05 which was significant at 0.05 level of significance. This implies that improved institutional related factors result in an increase in management outcome of triaged patients’. It’s therefore important to note that patients related factors, provider related factors and institutional related factors have an impact on the outcome of triaged and coded patients in accident and emergency department, Kenyatta national hospital. Thus, it’s important for the institution to invest in human resource capacity, procurement of equipment and drugs to be used as well as improve on infrastructure. Further research to be done to determine the patient satisfaction levels as well as the staff training needs assessment.